Understanding the meaning of the word "sex" has
implications for medical research and clinical practice. This is the
first study of a representative sample to assess attitudes about which
sexual behaviours constitute having "had sex" and to examine
possible mediating factors. A telephone survey of randomly selected
English-speaking residents of Indiana, US, was conducted, giving a
sample of 204 men and 282 women aged 18-96. Questions assessed attitudes
on manual-genital, oral-genital, penile-vaginal intercourse and
penile-anal behaviours. There was no universal consensus on which
behaviours constituted having "had sex". 95% responded
"yes" to penile-vaginal intercourse, bur this dropped to 89%
if there is no ejaculation. 81% responded "yes" to penile-anal
intercourse, and 71% and 73% responded "yes" to oral-genital,
either performing or receiving, respectively. Manual-genital was
endorsed more often when received (48.1%) than given (44.9%, p<
0.001). Among men, the oldest and youngest age groups were significantly
less likely to believe certain behaviours constituted having "had
sex". It is necessary to use behaviour-specific terminology in
sexual history taking, sex research, sexual health promotion and sex
education. Researchers, educators and medical practitioners should not
assume that their own definitions of having "had sex" are
shared by research participants or patients. (1)